Pain practice : the official journal of World Institute of Pain
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Measuring HRQOL is simple, inexpensive, permits the health status to be measured over time, and is useful to compare or initiate treatments and evaluate results, facilitating homogenization in patient inclusion. ⋯ Health-related quality-of-life measures detected significant differences in outcomes in patients infected by S. aureus compared with patients infected by other microorganisms. HRQOL measures may provide useful complementary information on outcomes after acute postoperative infection.
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Acute pain following amputation can be challenging to treat due to multiple underlying mechanisms and variable clinical responses to treatment. Furthermore, poorly controlled preoperative pain is a risk factor for developing chronic pain. Evidence suggests that epidural analgesia and peripheral nerve blockade may decrease the severity of residual limb pain and the prevalence of phantom pain after lower extremity amputation. ⋯ A multimodal analgesic regimen was utilized, including titration of preoperative opioid and neuropathic pain agents, perioperative intravenous, epidural and peripheral nerve catheter infusions, and postoperative oral medication titration. More than 8 months postoperatively, the patient has satisfactory pain control with no evidence for phantom limb pain. To our knowledge, there have been no publications to date concerning analgesic regimens in four-limb amputation.
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Multicenter Study
Validation of the Short Form of the Brief Pain Inventory (BPI-SF) in Spanish Patients with Non-Cancer-Related Pain.
The Brief Pain Inventory (BPI) is a widely used pain measurement tool. There are 2 versions, the BPI Long Form (BPI-LF) and Short Form (BPI-SF), which share 2 core scales measuring pain severity and pain interference but which use different recall periods (24 hours vs. 1 week). To date, the BPI-SF has not been validated for use in Spain. ⋯ Substantial improvements were seen on both subscales after 3 months of treatment (ES of 1.76 for pain severity and 1.51 for pain interference). Recall period did not noticeably affect scores; ICCs (95% CI) between the long and short versions were 0.946 (0.938 to 0.954) and 0.929 (0.919 to 0.939) for the severity and interference subscales, respectively. The Spanish version of the BPI-SF is a valid and reliable instrument to measure pain severity and interference.
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Case Reports
Surgical Site Infection 18 Months Following Intrathecal Pump Placement Secondary to an Asymptomatic Bowel Injury.
Surgical site infections following the implantation of intrathecal drug delivery systems typically present during the first 1 to 2 months following surgery. Surgical site infections occurring outside of this window are rare entities and require special attention to identify the source or underlying cause. In this report, we present a case of pump pocket infection 18 months following implantation due to an asymptomatic and unrecognized bowel injury associated with the catheter. This case highlights the need for a thorough evaluation in a patient with suspected infections more than 2 months after surgery to ensure adequate treatment.
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Randomized Controlled Trial Comparative Study
Comparison of High-voltage- with Standard-voltage Pulsed Radiofrequency of Gasserian Ganglion in the Treatment of Idiopathic Trigeminal Neuralgia.
Although pulsed radiofrequency treatment (PRFT) has been used to treat trigeminal neuralgia (TN) safely, satisfactory improvement is lacking. Recently, much attention has been paid to the PRFT dose and intra-operative parameters. It has been reported that high-voltage PRFT could significantly reduce discogenic pain. ⋯ The effective rate in the standard-voltage group decreased to 19% at 1-year postoperative, while in the high-voltage group remained at 69% (P = 0.000). No significant side effects were detected in both groups. In conclusion, CT-guided high-voltage PRFT is an effective and safe interventional therapeutic choice for idiopathic TN patients.